There are about 35,000 family doctors  (general practitioners) working in the NHS in Britain. There are currently more GPs than hospital consultants. Two thirds are men, and one third are women. Most of the men and around half of the women work full time. The doctors usually work in groups of between three and five, although some work single handed and some work in much larger groups. They are supported by nurses including midwives, health visitors, administration and clerical staff, and often other staff such as physiotherapists, dieticians, counsellors, psychiatric nurses and podiatrists. 

Doctors’ buildings may be owned by the doctors, or by the NHS, or private landlords. Sometimes general practitioners in Britain have beds in a nearby hospital. Levels of computerisation are high, and many practices have simple diagnostic equipment.

There a number of special features of British general practice:

·      The registered list.

·      The referral to specialist function

·      The patient record.

The registered list

Patients in the NHS register with a general practitioner who, on average, will look after around 2000 patients. Many patients stay with the general practitioner or practice for long periods or even throughout their lives unless they move away. Patients can only go to another GP in another practice in special circumstances. GPs are responsible for their patients 24 hours a day, 365 days a year. In most areas they work together in co-operatives to provide care at night and weekends. This care is usually provided from special centres. GPs in Britain look after the full range of patients including children, pregnant women and the mentally ill. Over 90% of all illnesses presenting to the NHS are dealt with entirely by GPs.

The referral to specialist function

In the NHS, patients can only be seen by hospital consultants if they are referred by their GP. The exception to this is emergencies, when they may go to the hospital accident and emergency departments. A minority of patients have private medical insurance, but even they have to be referred to a hospital consultant by their GP. GPs have open access to hospital pathology and radiology services, where patients can be investigated under the care of the GP. Only in rural areas do GPs have access to hospital beds where they can look after their own patients. Since access to specialists is largely controlled by GPs, most of the patients see a consultant in the right specialty.

The patient record

Because of the registered list and the referral to specialist function, GPs in Britain hold a complete patient record which contains details of all illnesses that have been dealt with by the GP and his staff, by hospital consultants or by accident and emergency departments. If a patient changes their GP, the record goes with them

Vocational training

Since 1974 all GP's have been vocationally trained. Training is usually two years in hospital in four different specialities, and one year in a GP training practice. The trainers are specially trained GP's who are paid to do this.

All doctors working in general practice today, whether as a principal, assistant, locum or deputy, must possess a certificate of prescribed or equivalent experience issued by the Joint Committee on Postgraduate Training for General Practice (JCPTGP), or a legal exemption, or an acquired right to practise. The only exceptions are doctors who are training in general practice (GP registrars) and those working outside the NHS, in private practice. (Ref.: “Working in general practice in the UK’ published by the JCPTGP.)

In Britain the General Medical Council has the responsibility for the recognition of certificates presented by doctors entering the UK from Europe to practise medicine.  

European Legislation

Doctors who possess a Certificate of Specific Training in General Medical Practice awarded in one of the member states of the European Economic Area (EEA) other than the UK are considered to have acquired rights to work in General Medical Practice. The European Doctors organization are pleased to assist Doctors qualified to work in general practice in another EEA country to obtain their certification as a GP in Britain. The family doctor is at the centre of a referral system involving district nurses, health visitors social workers etc. as well as more specialized doctors. A GP therefore needs wide background knowledge of the British social and medical system. Because of the specialist nature of the GP’s job in the NHS, European Doctors Limited can sometimes arrange short training/ refresher courses for GPs from EEA countries who have their Certificate of Specific Training in General Medical Practice from their own country. We believe that this training / refresher course will help a doctor work as a GP partner with much more understanding of the system and self confidence. 

Pay

The government announced in November 2001 that doctors joining the NHS as a GP for the first time, will receive a bonus payment of £5000 (£12,000 in certain shortage areas). General practitioners are either self-employed and contract their services to the NHS, or they are employed by other doctors. Payment is a complex system of rules but is direct from the NHS to the doctor. An average GP earns about the same as a hospital consultant, with a shorter period of training. Also many GPs can buy a part or the whole of the practice premises with an advantageous mortgage (property finance loan). This provides a useful lump sum on retirement. See also the section on “Doctor’s Pay in the NHS.”

Hours of Work

Nowadays there are deputising services which cover out of hours work in most parts of the country, and GPs do very little night work unless they wish to.

Prospects

The British government announced that it intends to increase the number of GPs by 2,000. Opportunities for permanent GP partnerships are currently excellent.

Every practice uses locums at times to do anything from an occasional surgery (consulting session) to a longer locum, for example covering maternity leave or a GP partner having a major operation. There is a tremendous shortage at present of suitably qualified doctors available for this, and a good way to find a congenial GP practice is first to work in the partnership as a locum.